Provider Demographics
NPI:1386905230
Name:ROBSON, BRYANNE (MD)
Entity type:Individual
Prefix:
First Name:BRYANNE
Middle Name:
Last Name:ROBSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1786 WILMINGTON W CHESTER PIKE STE 202A
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-8198
Mailing Address - Country:US
Mailing Address - Phone:610-557-8903
Mailing Address - Fax:610-486-3019
Practice Address - Street 1:1786 WILMINGTON W CHESTER PIKE STE 202A
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-8198
Practice Address - Country:US
Practice Address - Phone:610-557-8903
Practice Address - Fax:610-486-3019
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0012677207Q00000X
PAMT201249390200000X
PAMD453794207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program